Peipei Liu1,2, Yaoyao Sun1,2, Chongya Dong3, Dan Song1,2, Yanrong Jiang1,2, Jianhong Liang1,2, Hong Yin1,2, Xiaoxin Li1,2, Mingwei Zhao4,5. 1. Department of Ophthalmology, Peking University People's Hospital, Xizhimen South Street 11, Xi Cheng District, 100044, Beijing, China. 2. Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing, China. 3. Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. 4. Department of Ophthalmology, Peking University People's Hospital, Xizhimen South Street 11, Xi Cheng District, 100044, Beijing, China. zhaomingwei@medmail.com.cn. 5. Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing, China. zhaomingwei@medmail.com.cn.
Abstract
PURPOSE: To investigate whether a new macular hole closure index (MHCI) could predict anatomic outcome of macular hole surgery. METHODS: A vitrectomy with internal limiting membrane peeling, air-fluid exchange, and gas tamponade were performed on all patients. The postoperative anatomic status of the macular hole was defined by spectral-domain OCT. MHCI was calculated as (M+N)/BASE based on the preoperative OCT status. M and N were the curve lengths of the detached photoreceptor arms, and BASE was the length of the retinal pigment epithelial layer (RPE layer) detaching from the photoreceptors. Postoperative anatomical outcomes were divided into three grades: A (bridge-like closure), B (good closure), and C (poor closure or no closure). Correlation analysis was performed between anatomical outcomes and MHCI. Receiver operating characteristic (ROC) curves were derived for MHCI, indicating good model discrimination. ROC curves were also assessed by the area under the curve, and cut-offs were calculated. Other predictive parameters reported previously, which included the MH minimum, the MH height, the macular hole index (MHI), the diameter hole index (DHI), and the tractional hole index (THI) had been compared as well. RESULTS: MHCI correlated significantly with postoperative anatomical outcomes (r = 0.543, p = 0.000), but other predictive parameters did not. The areas under the curves indicated that MHCI could be used as an effective predictor of anatomical outcome. Cut-off values of 0.7 and 1.0 were obtained for MHCI from ROC curve analysis. MHCI demonstrated a better predictive effect than other parameters, both in the correlation analysis and ROC analysis. CONCLUSIONS: MHCI could be an easily measured and accurate predictive index for postoperative anatomical outcomes.
PURPOSE: To investigate whether a new macular hole closure index (MHCI) could predict anatomic outcome of macular hole surgery. METHODS: A vitrectomy with internal limiting membrane peeling, air-fluid exchange, and gas tamponade were performed on all patients. The postoperative anatomic status of the macular hole was defined by spectral-domain OCT. MHCI was calculated as (M+N)/BASE based on the preoperative OCT status. M and N were the curve lengths of the detached photoreceptor arms, and BASE was the length of the retinal pigment epithelial layer (RPE layer) detaching from the photoreceptors. Postoperative anatomical outcomes were divided into three grades: A (bridge-like closure), B (good closure), and C (poor closure or no closure). Correlation analysis was performed between anatomical outcomes and MHCI. Receiver operating characteristic (ROC) curves were derived for MHCI, indicating good model discrimination. ROC curves were also assessed by the area under the curve, and cut-offs were calculated. Other predictive parameters reported previously, which included the MH minimum, the MH height, the macular hole index (MHI), the diameter hole index (DHI), and the tractional hole index (THI) had been compared as well. RESULTS: MHCI correlated significantly with postoperative anatomical outcomes (r = 0.543, p = 0.000), but other predictive parameters did not. The areas under the curves indicated that MHCI could be used as an effective predictor of anatomical outcome. Cut-off values of 0.7 and 1.0 were obtained for MHCI from ROC curve analysis. MHCI demonstrated a better predictive effect than other parameters, both in the correlation analysis and ROC analysis. CONCLUSIONS: MHCI could be an easily measured and accurate predictive index for postoperative anatomical outcomes.
Authors: Arghavan Almony; Eric Nudleman; Gaurav K Shah; Kevin J Blinder; Dean B Eliott; Robert A Mittra; Asheesh Tewari Journal: Retina Date: 2012-05 Impact factor: 4.256
Authors: Yunzi Chen; Amar V Nasrulloh; Ian Wilson; Caspar Geenen; Maged Habib; Boguslaw Obara; David H W Steel Journal: BMJ Open Ophthalmol Date: 2020-08-16